Department of Obstetrics/Gynaecology, University of Alberta, Edmonton, Alberta, Canada.
Hypertension. 2012 May;59(5):1014-20. doi: 10.1161/HYPERTENSIONAHA.112.191825. Epub 2012 Mar 5.
Preeclampsia is a major cause of maternal and fetal morbidity and mortality that has been associated with endothelial dysfunction attributed, in part, to dyslipidemia, an imbalance in angiogenic factors and oxidative stress. One of the many factors that have been shown to be elevated in women with preeclampsia is low-density lipoprotein (LDL) and the more oxidizable, small dense LDL, which can lead to increased vascular oxidative stress and decreased bioavailability of NO. Lectin-like oxidized LDL-1 receptor (LOX-1) is a specific receptor for oxidized LDL. We hypothesized that a reduction of placental perfusion using a rat model of reduced uteroplacental perfusion pressure would result in enhanced LOX-1 expression in the maternal vasculature causing impaired vascular endothelial function through the actions of increased superoxide production and decreased NO-mediated vasodilation. We demonstrated a significant increase in the expression of the LOX-1 receptor (4.3-fold; P=0.002), endothelial NO synthase (2.7-fold; P=0.001), and superoxide (P=0.02) in thoracic aorta of the reduced uteroplacental perfusion pressure model, whereas maximal vasodilator function was modestly decreased (P<0.05). Endothelial-dependent vasodilator function was unaffected by either oxidized LDL or an LOX-1 receptor inhibitor in controls but was modestly increased in the presence of both oxidized LDL and the LOX-1 receptor inhibitor in reduced uteroplacental perfusion pressure (P=0.03). In summary, we have shown that, in a rat model of preeclampsia, there is a dramatic increase in the expression levels of both the LOX-1 receptor and the endothelial NO synthase enzyme, along with evidence of increased superoxide production and subsequent modestly decreased endothelial function.
子痫前期是孕产妇和胎儿发病率和死亡率的主要原因,部分与内皮功能障碍有关,这归因于血脂异常、血管生成因子和氧化应激的不平衡。已经证明在子痫前期妇女中升高的众多因素之一是低密度脂蛋白(LDL)和更易氧化的小而密 LDL,这会导致血管氧化应激增加和 NO 的生物利用度降低。凝集素样氧化 LDL-1 受体(LOX-1)是氧化 LDL 的特异性受体。我们假设,使用减少子宫胎盘灌注压的大鼠模型减少胎盘灌注会导致母体血管中 LOX-1 表达增强,通过增加超氧化物产生和减少 NO 介导的血管舒张来导致血管内皮功能受损。我们证明,在减少子宫胎盘灌注压模型的胸主动脉中,LOX-1 受体(增加 4.3 倍;P=0.002)、内皮型一氧化氮合酶(增加 2.7 倍;P=0.001)和超氧化物(P=0.02)的表达显著增加,而最大血管舒张功能略有下降(P<0.05)。在对照组中,氧化 LDL 或 LOX-1 受体抑制剂对内皮依赖性血管舒张功能没有影响,但在减少子宫胎盘灌注压的情况下,两者同时存在时,内皮依赖性血管舒张功能略有增加(P=0.03)。总之,我们已经表明,在子痫前期的大鼠模型中,LOX-1 受体和内皮型一氧化氮合酶酶的表达水平都显著增加,同时还存在超氧化物产生增加和随后的内皮功能略有下降的证据。